Erythrocyte blood parameters , ESR - Causes , Symptoms and Treatment .MF .

August 12, 2017 17:52 | Laboratory

Hemoglobin (Hb, hemoglobin)

respiratory pigment of blood, involved in the transport of oxygen and carbon dioxide, is also performing buffering functions (maintenance of pH).Contained in the erythrocytes (red blood cells).It consists of a protein part - globin - and iron-porphyrin part - heme.This protein quaternary structure formed by four subunits.Heme iron is in divalent form.

Physiological forms of hemoglobin:

1) oxyhemoglobin (HbO2) - Connect hemoglobin with oxygen is produced mainly in the arterial blood and gives it a red color (oxygen binds to the iron atom by coordination bond);2) reduced hemoglobin and deoxyhemoglobin (HbH) - hemoglobin, who gave oxygen tissues;3) carboxyhemoglobin (HbCO2) - Connect the hemoglobin with carbon dioxide;formed mainly in venous blood, which thereby acquires a dark cherry color.

Pathological forms of hemoglobin:

1) karbgemoglobin (HbCO) - formed in cases of poisoning by carbon monoxide (CO), the hemoglobin loses its ability to attach oxygen;

2) methemoglobin - is formed by the action of nitrites, nitrates and certain medications (a transition of divalent iron in the trivalent to form methemoglobin -. HbMet

content of hemoglobin in men is slightly higher than that of women have children in the first year of life there.a physiological decline in hemoglobin concentration. The decrease in hemoglobin in the blood (anemia) can be the result of elevated hemoglobin loss at all sorts of bleeding or increased destruction (hemolysis) of red blood cells. The cause of anemia can be a lack of iron, necessary for the synthesis of hemoglobin, or vitamins involved in the formation of red blood cells. (especially B12, folic acid), as well as violation of the formation of blood cells under specific hematological diseases Anemia may occur secondary to various kinds of chronic non-hematological diseases

units:.. g / dL
Alternative units:
g /l.
conversion factor:
g / l x 0,1 == & gt;g / dL.
Reference Range:

Age, gender hemoglobin, g / dL
& lt;2 weeks 13,4 - 19,8
2 - 4.3 weeks 10,7 - 17,1
4,3 - 8,6 weeks 9,4 - 13,0
8, 6 weeks - 4 months. 10,3 - 14,1
4 - 6 months 11,1 - 14,1
6 - 9 months 11,4 - 14,0
9 - 12months 11,3 - 14,1
1 - 5 years 11,0 - 14,0
5 - 10 years 11,5 - 14,5
10 -12 years 12,0 - 15,0
12 - 15 years Women 11,5 - 15,0
Men 12,0 - 16,0
15- 18 Women 11,7 - 15,3
Men 11,7 - 16,6
18 - 45 years Women 11,7 - 15,5
Men 13,2 - 17,3
45 - 65 years Women 11,7 - 16,0
Men 13,1 - 17,2
& gt;65 Women 11,7 - 16,1
Men 12,6 - 17,4

Raising hemoglobin levels:

  1. diseases accompanied by an increase in the number of red blood cells (primary andsecondary erythrocytosis);
  2. blood clots;
  3. congenital heart defects;
  4. pulmonary heart disease;
  5. physiological reasons (the inhabitants of the highlands, the pilots after the flight altitude, climbers, after increased physical activity).

Decrease in hemoglobin:

anemia of various etiologies (primary symptom).

Hematocrit (Ht, hematocrit)

hematocrit - a share (%) of the total blood volume, which make red blood cells.Hematocrit reflects the ratio of red blood cells and plasma, rather than the total number of red blood cells.For example, patients in shock due to blood clots hematocrit may be normal or even higher, although, due to loss of blood, the total number of erythrocytes can be significantly reduced.Therefore, the hematocrit can not be used to assess the degree of anemia shortly after blood transfusion or loss.Hematocrit may slightly decrease when drawing blood in the supine position.Falsely elevated results may occur with prolonged tourniquet compression of the veins when drawing blood.False decrease in hematocrit may occur due to blood dilution (taking blood from the same limb directly after intravenous administration).

Units: %.
Reference Range:

Age, gender The hematocrit,%
& lt;2 weeks 41 - 65
2 - 4.3 weeks 33 - 55
4,3 - 8,6 weeks 28 - 42
8, 6 weeks - 4 months. 32 - 44
4 - 6 months 31 - 41
6 - 9 months 32 - 40
9 - 12 months 33 - 41
1 -3 years 32 - 40
3 - 6 years 32 - 42
6 - 9 years 33 - 41
9 - 12 years 34 - 43
12 - 15 years Women 34 - 44
Men 35 - 45
15 - 18 years Women 34 - 44
Men 37 - 48
18 - 45 years Women 35 - 45
Men 39 - 49
45 - 65 years Women 35 - 47
Men 39 - 50
& gt;65 Women 35 - 47
Men 37 - 51

Increased hematocrit:

  1. erythremia;
  2. symptomatic erythrocytosis (congenital heart defects, respiratory failure, hemoglobinopathies, kidney tumors, accompanied by increased formation of erythropoietin, polycystic kidney disease);
  3. hemoconcentration in burn disease, peritonitis, dehydration (in severe diarrhea, uncontrollable vomiting, excessive sweating, diabetes).

lowering hematocrit:

  1. anemia;
  2. hyperhydration;
  3. second half of pregnancy.

erythrocytes (red blood cells, red blood cells, RBC)

Red blood cells - blood cells that contain hemoglobin, transporting oxygen and carbon dioxide.Mature red blood cells do not contain nuclei, are disc-shaped.The average life span of red blood cells - 120 days.Neonates erythrocyte size is slightly larger than that of adults.Increasing the number of red blood cells called erythrocytosis (poliglobuliey).

reduction in the number of red blood cells (hemoglobin) - anemia . physiological erythrocytosis observed in newborns in the first days of life, with stress, increased physical activity, sweating, fasting.The number of red blood cells may be more physiologically down after a meal, in the period between 17.00 and 7.00 hours, as well as the taking of blood in the supine position.After prolonged tourniquet compression is possible to obtain falsely elevated results.In addition to determining the number of erythrocytes in the diagnosis uses a number of morphological characteristics of red blood cells, which are measured by an automatic analyzer (see Erythrocyte indices MCV, MCH, MCHC.), Either visually - in a blood smear under the microscope when calculating leykoformuly.Normally, the diameter of the red blood cells is 7.2 - 7.5 microns.Erythrocytes 6.7 microns or less in diameter called microcytes, more than 7.7 microns - macrocytes, more than 9.5 microns in diameter - megalocytes.

macrocytosis - a condition where 50% or more of the total number of red blood cells constitute macrocytes.It is noted at the B12 and folic acid deficiency anemia, liver disease.

Age, gender level of red blood cells, one million cells / mm
& lt;2 weeks 3,9 - 5,9
2 - 4.3 weeks 3,3 - 5,3
4,3 weeks - 4 months. 3,5 - 5,1
4 - 6 months. 3,9 - 5,5
6 - 9 months. 4,0 - 5,3
9 - 12 months. 4,1 - 5,3
1 - 3 years 3,8 - 4,8
3 - 6 years 3,7 - 4,9
6 - 9years 3,8 - 4,9
9 - 12 years 3,9 - 5,1
12 - 15 years Women 3,8 - 5,0
Men 4,1 - 5,2
15 - 18 years Women 3,9 - 5,1
Men 4,2 - 5,6
18- 45 years Women 3,8 - 5,1
Men 4,3 - 5,7
45 - 65 years Women 3,8 - 5,3
Men 4,2 - 5,6
& gt; & gt;65 Women 3,8 - 5,2
Men 3,8 - 5,8

Increased levels of red blood cells (polycythemia):

  1. erythremia or Vakeza disease - onevariant of chronic leukemia (primary polycythemia);
  2. secondary erythrocytosis: a) absolute - under hypoxic conditions (chronic lung disease, congenital heart defects, stimulate erythropoiesis (hypernephroma, Cushing's disease, hemangioblastoma of the cerebellum), when there is a stimulation of erythropoiesis and increase in the number of red blood cells, and b) the relative - in thickeningblood (excessive sweating, vomiting, diarrhea, burns, increasing edema and ascites) when the plasma volume decreases, while maintaining the number of red blood cells.

Lowering the level of red blood cells (erythropenia):

  1. deficiency anemia of different etiology - as a result of iron deficiency, protein, vitamins, aplastic protsesov;
  2. hemolysis;
  3. leukemias, myeloma;
  4. metastasis of malignant tumors.

Erythrocyte indices

Erythrocyte indices - is the calculated values ​​that allow quantify the important indicators of the state of red blood cells.MCV - average volume of red blood cell (mean cell volume).This is a more accurate parameter than visual assessment of the size of red blood cells.However, it is not reliable when a large amount of red cells with altered form.On the basis of the values ​​of MCV differentiate microcytic anemia (iron deficiency, thalassemia), normocytic and macrocytic. microcytosis characteristic of iron deficiency anemia, macrocytosis - for B12 and folic acid. Aplastic anemia is normo - or macrocytic.

Reference Range:

Increased MCV:

  1. megaloblastic anemia (B12 deficiency, folic acid);
  2. macrocytosis (aplastic anemia, hypothyroidism, liver disease, metastasis of malignant tumors);
  3. smoking and drinking.

Lowering MCV:

  1. hypochromic and microcytic anemia (anemia, iron deficiency, chronic disease, thalassemia);
  2. hemoglobinopathies;Hyperthyroidism (rare).

MCH - average content of hemoglobin in the red blood cell (mean cell hemoglobin).

calculated in absolute terms by dividing the hemoglobin concentration by the number of red blood cells.This parameter defines the average content of hemoglobin in the red blood cell and a separate indicator is similar to the color, but more accurately reflects the synthesis of Hb and erythrocyte levels.Based on this index anemia can be divided into normo-, hypo- and hyperchromic.Normohromiya characteristic for healthy people, but can occur and hemolytic, and aplastic anemia and anemia associated with acute blood loss.Hypochromia due to a decrease in red blood cell volume (microcytosis) or a decrease in hemoglobin levels to normal red blood cell volume.E. Hypochromia can be combined with a decrease in the volume of red blood cells, and observed in standard-setting and macrocytosis.Hyperchromia independent of the degree of saturation of erythrocytes, hemoglobin, and is caused only by the volume of red blood cells.

Units and conversion factors: pg (picograms).

Reference Range:

Age, gender
MCV, fl
& lt;2 weeks 88 - 140
2 - 4.3 weeks 91 - 112
4,3 - 8,6 weeks 84 - 106
8,6 weeks.- 4 months. 76 - 97
4 - 6 months. 68 - 85
6 - 9 months. 70 - 85
9 - 12 months. 71 - 84
1 - 5 years 73 - 85
5 - 10 years 75 - 87
10 - 12 years 76 - 94
12 -15 years Women 73 - 95
Men 77 - 94
15 - 18 years Women 78 - 98
Men 79 - 95
18 - 45 years Women 81 - 100
Men 80 - 99
45 - 65 years Women 81 - 101
Men 81 - 101
& gt; & gt;65 Women 81 - 102
Men 81 - 103
Age, gender
MCH, pg
& lt;2 weeks 30 - 37
2 - 4.3 weeks 29 - 36
4,3 - 8,6 weeks 27 - 34
8,6 weeks.- 4 months. 25 - 32
4 - 6 months. 24 - 30
6 - 9 months. 25 - 30
9 - 12 months. 24 - 30
1 - 3 years 22 - 30
3 - 6 years 25 - 31
6 - 9 years 25 - 31
9 -15 years 26- 32
15 - 18 years Women 26 - 34
Men 27 - 32
18 - 45 years Women 27 - 34
Men 27 - 34
45 - 65 years Women 27 - 34
Men 27 - 35
& gt; & gt;65 Women 27 - 35
Men 27 - 34

Improving SIT:

  1. megaloblastic anemia (vitamin B12 and folic acid);
  2. liver disease;
  3. false increase (multiple myeloma, hyperskeocytosis).

Lowering MCH: iron deficiency anemia

MCHC (mean cell hemoglobin concentration) - the average concentration of hemoglobin in the red blood cell

is calculated by dividing the concentration of hemoglobin (in g / 100 ml), hematocrit and multiplying by 100. The indicator reflects the saturation of hemoglobin in red blood cell;It is the ratio of the amount of hemoglobin in the cell volume.It is independent, so the volume of cells, as opposed to MSN.

Units: g / dL. Alternative Units: g / l. conversion factor: g / l x 0,1 == & gt;g / dL.

Reference Range:

Age, gender
MCHC, g / dL
& lt;2 weeks 28 - 35
2 - 4.3 weeks 28 - 36
4,3 - 8,6 weeks 28 - 35
8,6 weeks.- 4 months. 29 - 37
4 - 12 months. 32 - 37
1 - 3 years 32 - 38
3 - 12 years 32 - 37
12 - 15 years Women 32 - 36
Men 32 - 37
15 - 18 years Women 32 - 36
Men 32 - 36
18 - 45 years Women 32 - 36
Men 32 - 37
45 - 65 years Women 31 - 36
Men 32 - 36
& gt; & gt;